Book Review: Hunger Games

I waffle back and forth on what to read for fun during residency. During the day we are so inundated with complex information, journal articles, diagrams and tables, that occasionally we go home and simply want something to entertain. The Hunger Games by Suzanne Collins did just that. A science fiction novel similar to Ender's Game, it features a futuristic dystopia where a child protagonist is pitted against an all-powerful evil government. It's not an incredibly sophisticated book, but it's an easy page-turner that kept me up past my bedtime. Although it could have done more as a moral and psychological bildungsroman, it instead sells itself as a thriller. However, the rest of the trilogy disappointed me; it seemed as though the author lost control of her characters and plot. But the first book of the series was definitely a diversion from residency.

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Book Review: Final Exam

I recently read Pauline Chen's Final Exam, a narrative nonfiction on a surgeon's perspective on death and dying. It's interesting; many of the sentiments, experiences, and thoughts expressed in the book are reflected in my blogs over the last five years. The surgical approach, however, is fascinating. She speaks of issues specific to surgeons - the idea of performing an operation on someone who subsequently dies, the infamous morbidity and mortality conferences, the surgical culture.

The writing in the book is excellent; it's clear, articulate, eloquent, graceful. The chapters read almost like essays with interwoven patient narratives and stories. To be honest, reading it felt like re-experiencing that which I'd already seen, so I don't think I particularly learned or gained much. It might not be the right book for a resident or physician. But I think it's a great read for the pre-med or interested layperson. The literature on death and dying perseverates on the disconnect between physicians and their familiarity, comfort, and understanding of the end of life. But what I'm trying to find goes beyond that - I know what it's like to care for a dying person, but my question is how we can change the system, structure, people, education, or expectations to make it better.

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Book Review: The Barnum Museum

One of the great things about vacation is the time to read for fun. Steven Millhauser's The Barnum Museum is a collection of short stories, and I really enjoyed two in particular. The title story, "The Barnum Museum", is a story about a location that treads the quiet line between the real and the fantastical. This museum carries an air of mystique, and the atmosphere Millhauser creates is truly magical. The last story of the collection, "Eisenheim the Illusionist", is an amazing story, now made into a movie (The Illusionist 2006) about a magician during turn-of-the-19th century Vienna whose magic tricks take on more and more wondrous feats. In any case, I highly recommend those two stories for anyone who likes fiction that encroaches the border of magic realism.

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W;t

I recently reread the play W;t by Margaret Edson. I had initially read this as a freshman in college for one of my introduction to the humanities courses (I had taken a course called "visions of mortality" - which probably lead to my current fascination with death and dying). I was really struck by this 1999 Pulitzer Prize winner and the film version starring Emma Thompson. I do not read a lot of plays, and I'm not sure I even know how to read a play, but I can say that this short, easy read works a number on the emotions and strikes at the core of end-of-life care and oncology. It describes a professor of English with terminal cancer and her interactions with the oncologists and nurses as she undergoes chemotherapy. The play ties in the Holy Sonnets of John Donne, including Holy Sonnet X (below) which addresses death directly. The language of the play reflects the clinical encounters patients often have, and the self-reflection of the main character reveals the rich internal dialogue that presumably patients have as well. Overall, it is one of the best reads for understanding the patient perspective of cancer and I recommend it to everyone in medicine.

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Holy Sonnet X
John Donne

Death, be not proud, though some have called thee

Mighty and dreadful, for thou art not so;

For those, whom thou think'st thou dost overthrow,

Die not, poor Death, nor yet canst thou kill me.

From rest and sleep, which but thy picture[s] be,

Much pleasure, then from thee much more must flow,

And soonest our best men with thee do go,

Rest of their bones, and soul's delivery.

Thou'rt slave to Fate, chance, kings, and desperate men,

And dost with poison, war, and sickness dwell,

And poppy, or charms can make us sleep as well,

And better than thy stroke; why swell'st thou then?

One short sleep past, we wake eternally,

And Death shall be no more, Death, thou shalt die.

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Book Review: Who Will Run the Frog Hospital?

Who Will Run the Frog Hospital? by Lorrie Moore is a novella I recently read, and I love it. It has nothing to do with medicine (do not worry, I did not hope to discover medicine in the title), but it was an easy piece of fiction a friend found for me. Lorrie Moore is a fantastic writer, and I had only read her short stories previously. But this book reads as one of her short stories; it is witty and conversant, aching of personal triumph and poignancy. This novella is a bildungsroman of a woman as she looks back at a loss of innocence and a time of transition in her young adulthood. But what it's about is not as important to me as how it makes me feel; her words have such a genuine ring as she prods and probes our own insecurities about adolescence. I would entirely recommend it as a good rainy-day read.

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Book Review: Superfreakonomics

Reading during residency is hard, but I picked up this book a while ago. I really enjoyed its predecessor Freakonomics, but to be honest, the sequel fell short of expectations. Although most of its topics are superficially interesting, it did not carry that interest through for me. Other than the chapter 0n global warming, I found the writing, research, and revelations to be lukewarm at best. They make a big deal over not having a "unifying theme" but I think that's what killed the book; the writing tried too hard and the train of thought wasn't all too coherent. Unfortunately, I would not recommend this book.

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Self-Made Man

Self-Made Man by Norah Vincent was one of the best books I've read in a long time. Written by a lesbian journalist, it recounts a 1 1/2 year experiment during which the author masquerades as a man in an experiment on gender, stereotypes, perceptions, and identity. She changes her wardrobe, dons a fake stubble, and takes voice lessons to pass as a man. She then joins an all-male bowling team, frequents strip clubs, dates women, joins a monastery, finds a job, and attends a John Bly mythopoetic men's movement group.

The idea of infiltrating a different group, whether gender, race, nationality, or other demographic is not new. But this book was an amazingly frank personal account of this experience. What I appreciated was that Norah Vincent says up front that this is not a sociologic expose or rigorous study of gender, rather, it is simply what she learned. She does not make any sweeping conclusions and indeed cautions against such stereotyping.

And yet, the content and epiphanies of this book are insightful, fascinating, and possibly true. She discusses the way men interact with each other, the differences of the job interview for a man versus a woman, the restriction on public emotion men have, the internal conflicts and burdens they carry, the attitudes about sex each gender has. She does this in a surprisingly neutral manner; she does not take a feminist standpoint and accuse men of all that is wrong in the world but neither does she coddle men and say it's understandable why they behave the way they do.

What I've taken away is that gender stereotyping ("that's just the way women are") is a myopic way of viewing the world. I've gained a little more insight into why people make judgments based on gender. I've learned a little more about gender in relationships, values, communication, and sex. Furthermore, this book has a fascinating psychological insight into personal identity and its relation to gender.

Lastly, the book is humorous and edgy. The writing is fabulous. I should note the language used and situations described may be offensive to some people. But I think Self-Made Man makes for a lot of great thinking and discussion.

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The Checklist Manifesto

I really enjoy Atul Gawande's writing, and The Checklist Manifesto did not disappoint. This book differs from his previous ones Complications and Better because it is not simply a collection of interesting stories and topics. Instead, it has a clear thesis promoting the use of the checklist. It reminds me of the previous books I reviewed, Internal Bleeding by Robert Wachter, another patient safety advocate. In this book, Gawande spreads his survey widely, looking at how top restaurants are run, how skyscrapers are built, and how international medicine is practiced. The timeliness of his book is amazing in that he describes very current events and how they played out.

His writing style is clear, engaging, cohesive, and precise. He incorporates both the dramatic narrative we've come to enjoy and the science; he describes his clinical research with the WHO and the study design in a fashion far more convincing and interesting than the medical journal article it produced. His writing is accessible to anyone, not just health care professionals.

The argument is not particularly new, innovative, or brilliant, but the way he puts it together is persuasive. He tells us what we already know - medicine is hard. It's complicated and complex, much like flying an airplane. Checklists allow a basic framework that demonstrably improves outcomes. Communication between team members is central to taking care of a patient. All of these concepts are simple, yet their implementation in modern medicine is slow and incomplete. The Checklist Manifesto explores why and how things should change.

This New York Times Bestseller and Amazon Best Book of the Month is a must-read for anyone interested in health policy and health outcomes, and it is a highly recommended read for everyone else. It certainly has changed the way I view the world. Those who know me know that I love lists; ever since college, I've made a checklist of things to do pretty much every day (and I pretty much never accomplish all the things on my list). The checklist works; I'm sold on the idea.

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Staying Human during Residency Training

Staying Human during Residency Training by Allan Peterkin is a must-read for residents and residents-to-be. Written by a psychiatrist in Canada, it addresses all the scary non-medical issues for residents: anxiety, depression, substance abuse, relationship stressors, suicide, harassment, and burnout. But more than that, it covers these topics in a surprisingly scientific and evidence-based fashion; he goes beyond the touchy-feely to engage the scientific-minded reader with numbers, statistics, and studies. We learn that 30% of emergency room residents have PTSD symptoms, 37-40% of residents report problems with their spouse or lover, 31% of doctors under 40 would not have gone to medical school if they had known what they know now, and the average U.S. resident salary works out to be less than $5 an hour.

This is a scary reality. Dr. Peterkin then delves into ways of ameliorating this experience, to temper down those stresses of residency so we can focus on patient care and education. He discusses how to find balance, stay healthy, maintain good relationships, work with colleagues, learn and teach, and remain professional. I found this book to be quite enlightening and relevant to me. He writes in a empathetic, clear, and authoritative way to openly discuss residency life and how to approach it.

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Mystery Ride

Robert Boswell's Mystery Ride is the latest fiction novel I've read. I was introduced to this book in the first creative writing course I took, a sophomore at Stanford. We read the first three chapters as an introduction to character and tension, and I was intrigued. I then met Robert Boswell at the Napa Valley Writers' Conference last summer. I really liked him; he was a captivating lecturer and his stories are hilarious and discomforting at the same time.

Like most American novels, Mystery Ride is a story of a dysfunctional American family, tracing the interaction of several families in various states of divorce, affairs, infatuation, religion, teenage rebellion, and pregnancy. He sets this clash of culture on the backdrop of California and a farm in Iowa. His characterization is amazing, and the situations conjured by his characters have intense drama, emotion, and tension. The dialogue is witty, the character development is believable, and the details are vivid. I recommend this novel to any avid reader. In it, Boswell really attempts to capture what it means to love, what it means to live.

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Match Day (Book Review)

Match Day by Brian Eule is a narrative account of three women as they approach that culmination of fourth year of medical school, match day. On match day, medical students across the country find out whether and where they are going to residency. To most, if not all, it's a stressful experience filled with uncertainty, second-guessing, and doubt. In this book, Brian Eule takes an almost anthropological approach in describing the entire process of specialty decision-making, residency interviews, and the ranking system. His only connection to medicine is his wife going through this process.

I picked this book up because the author describes his wife who went to Stanford undergrad and UCSF medical school. However, the target audience of the book is not third or fourth year medical students because we already know the nuts and bolts of the match process. Instead, I think those who would enjoy the book and learn the most would be significant others of medical students, pre-meds, or those early in medical school who don't fully understand this whole application process.

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